Monday, May 5, 2008

The Perils of Prescribed Pill Popping

Check out the highlights from a recent article from Medscape Rheumatology, discussing patient adherence to prescription medications. Taking your meds when and how you're supposed to can be tricky. I even created an excel spreadsheet so that I could track all of my prescriptions. When you're pill popping as much as Lupites have to sometimes, it's impossible to remember what you're taking or when, without writing it down. In the next few days, check back for a sample of my drug journal, fondly referred to as my "Chronic Control" spreadsheet!

Here are the article highlights:

People who are prescribed self-administered medications typically take less than half the prescribed doses. (Can you believe that?!) Many reasons exist for nonadherence to medical regimens. They include problems with the regimen (such as adverse effects), poor instructions, poor provider-patient relationship, poor memory, patients' disagreement with the need for treatment, or patients' inability to pay. Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications but also might increase their adverse effects. In this current review of trials of ways to help people follow prescriptions, updated from the 2005 version, 21 new studies were reviewed.

The aim of this study was to update a review summarizing the results of RCTs (randomized controlled trials) of interventions to help patients follow prescriptions for medications for medical problems, including mental disorders but not addictions.

Study HighlightsArticles were selected if they reported an unconfounded RCT of an intervention to improve adherence with prescribed medications, measuring both medication adherence and treatment outcome, with at least 80% of follow-up of each group studied and, for long-term treatments, at least 6 months' follow-up for studies with positive initial findings.

The studies differed widely according to medical condition, patient population, intervention, measures of adherence, and clinical outcomes; therefore, a qualitative analysis was performed.

For long-term treatments, 36 of 81 interventions reported in 69 RCTs were associated with improvements in adherence, but only 25 interventions led to improvement in at least 1 treatment outcome.

Almost all of the interventions that were effective for long-term care were complex, including combinations of more convenient care, information, reminders, self-monitoring, reinforcement, counseling, family therapy, psychological therapy, crisis intervention, manual telephone follow-up, and supportive care. This implied that more frequent interaction with patients with attention to adherence may be needed.

Even the most effective interventions did not lead to large improvements in adherence and treatment outcomes.

What's this all mean? It's up to you to make sure you take your meds when and how you're supposed to. The drugs designed to make you feel better aren't going to do you any good if you don't take them, take them too close together (or too far apart), or combine them with other substances that counteract their effects. Follow your doctor's orders to a "T", read the information packet that comes with your prescriptions, and you'll be that much closer to finding a drug combo that works for you.

1 comment:

Glad to hear you are managing your Lupus after 7 years. I'll have to admit I do not know a lot about the disease, but from your post, it seems as if there is a complex medication regime you have to follow.

If you are having trouble remembering to take your meds, please visit www.intelecare.com and sign up for our free email, text and voice medical reminders. Registration is just 5 steps - not too much information required - just how and when you would like to receive your reminders.

There is a drop down menu with the 300 most prescribed drugs, and you can add your own if not listed. There are also reminders available for prescription refills, doctor's appointments and vitals monitoring. All with space available to create a personalized message.

I hope Intelecare can help! Please let me know if you can recommend a good lupus non profit that might benefit from our pro bono email reminder platform.

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Sara Gorman

In 2001, I was diagnosed with systemic lupus, at the age of 26. I had been married less than 6 weeks and was at a highpoint in my career in television production. While I fought to keep hold of the life I'd known - demanding, yet fulfilling career, busy social life, packed vacation schedule - after four years of running my body into the ground, I realized I was fighting life, not living it. Thus, I downshifted almost every aspect of my life. I let go of my career and made it my number one priority to get myself back in good health. I'm proud to say that I've reached my goal, but work each day to maintain that healthy lifestyle. despite lupus. My book details the steps it took to reach that goal. A native of Indiana and graduate of the University of Notre Dame, I reside in Alexandria, Virginia with my husband, two young daughters, and pug dog.